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PTRS 745 Exam 1 > Manual Therapy > Flashcards

Manual Therapy Flashcards

1
Q

Term: Skilled hand movements to mobilize soft tissue and joints for the purpose of pain modulation, increase ROM, decrease soft tissue inflammation

A

Manual therapy

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2
Q

Q: What are 3 reasons for using manual therapy?

A
  1. Pain modulation 2. Increase ROM 3. Decrease soft tissue inflammation
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3
Q

Term: Manual therapy techniques comprised of skilled passive movements to joints that are applied at varying speed and amplitudes.

A

Mobilization/manipulation

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4
Q

Term: a passive movement technique performed by an operator in a manner that is at all time within the ability of the pt. to prevent the movement

A

Mobilization

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5
Q

Term: A passive movement technique performed at the limit of the available passive range at a speed that is beyond the pt.’s control

A

Manipulation

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6
Q

Term: High velocity, low amplitude therapeutic movements applied within or at end ROM

A

Thrust manipulation

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7
Q

Term: speed

A

Velocity

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8
Q

Term: Distance

A

Amplitude

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9
Q

Term: force

A

Thrust

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10
Q

Content: Two types of mobilization

A
  1. Passive physiological movement (PPM) or osteokinetmatics
  2. Passive accessory movement (PAM) or arthrokinematics or joint play
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11
Q

Content: limitation to motion - osteokinematics (3)

A
  1. muscle or soft tissue
  2. joint capsule
  3. joint play
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12
Q

Content: limitation to motion - arthrokinematics (4)

A
  1. Ligaments
  2. Bone congruence
  3. Intra-articular cartilage
  4. Joint capsule
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13
Q

Q: What is are examples of PPM?

A

Flexion/extension, ABD/ADD, IR/ER

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14
Q

Q: What is are examples of PAM?

A

Roll, glide, spin, distraction/compression

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15
Q

T/F: Manipulation is within the scope of PT practice.

A

True

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16
Q

T/F: PT and Chiropractors are solely responsible for manual therapy.

A

True

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17
Q

Q: What is the difference between PT and Chiropractors?

A
  1. Philosophy is different
    - Chiropractor - manipulation can treat and cure any aliment
    - PT - use manipulation to decrease pain and increase mobility
  2. Technique is different
    - Chiropractor = long levers
    - PT = short levers
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18
Q

T/F: PTs perform chiropractic manipulations.

A

False

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19
Q

Q: Which should you pay more attention to the broad, nationwide practice act or the state specific practice act?

A

State practice acts

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20
Q

T/F: Grade 5 manipulation is within KS state practice act

A

True

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21
Q

Q: Which 3 states do not allow grade 5 manipulation?

A
  1. Arkansas
  2. West Virginia
  3. Washington
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22
Q

T/F: Students do not follow the practice pattern of their CIs and their decisions are not influenced by their CIs practice patterns.

A

False

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23
Q

Q: Manual therapy is ____________ for certain people when __________ with certain __________.

A

Beneficial, performed, exercises

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24
Q

Content: Possible mechanism for manual therapy (3)

A
  1. Neuorphysiological
  2. Mechanical
  3. Psychological/placebo
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25
Q

Content: Neurophysiological mechanism (4)

A
  1. descending pain inhibitory system
  2. endogenous opioid release
  3. gate control theory
  4. change in reflex excitability
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26
Q

Content: Mechanical mechanism (3)

A
  1. free up entrapped/torn meniscoid
  2. mechanical disruption to intra-articular adhesion
  3. stretching of joint capsule
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27
Q

Content: Absolute contraindications for manual therapy (8)

A
  1. Malignancy
  2. Neurological - cauda equina syndrome
  3. Vascular
  4. Bone disease
  5. Inflammatory conditions
  6. Infection
  7. Acute symptomatic disc herniation
  8. Undiagnosed pain
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28
Q

Content: Relative contraindications for manual therapy (12 - general idea)

A
  1. RA
  2. Osteoporosis
  3. Spondylolisthesis
  4. Hypermobility/instability
  5. Pregnancy
  6. Previous malignant disease
  7. Acute trauma
  8. Protectice spasm
  9. Gross degenerative changes
  10. Psychological pain
  11. Steroid or anitcoagulant
  12. Severe nerve root pain
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29
Q

Q: How does the therapists perspective alter the placebo effect?

A

Communication, use the placebo effect to your advantage

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30
Q

Content: Precautions for manual therapy (5)

A
  1. Recent trauma
  2. Ligament injury
  3. Post-op
  4. Empty end feel or muscle spasm
  5. acute inflammation
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31
Q

Content: Indications for manual therapy (5)

A
  1. mild or moderate pain of musculoskeletal origin
  2. joint hypomobility
  3. a non-irritable mild/moderate irritable condition
  4. remodeling stage of recovery - subacute
  5. acute spinal pain without neurological symptoms
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32
Q

Content: Kaltenborn distraction grading system (3)

A

Grade 1 = unloading and decompressing the joint surfaces

Grade 2 = separation of joint surfaces

Grade 3 = joint capsule and ligament stretch

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33
Q

Q: _____ seconds of static hold for pain, ______ seconds for stretching joint capsule (Kaltenborn).

A

10-20, 30-60

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34
Q

Diagram: Maitlan grading system - grades of movement for accessory glides

A
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35
Q

Content: Maitland grading system (5)

A

Grade 1 = small amplitude in the resistance free range (1st 25%)

Grade 2 = large amplitude in the resistance free range (middle 50%)

Grade 3 = large amplitude into resistance or up to resistance (last 50%)

Grade 4 = small amplitude into resistance (last 25%)

Grade 5 = (manipulation) high velocity, small amplitude, thrust movement to the limit of available range or mid range

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36
Q

Diagram: Fill in the table below

A
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37
Q

T/F: The grades are based on the normal range.

A

False, based on restrictions

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38
Q

T/F: These grades are progressive.

A

False: Grade 1 and 4 are similar just performed at different ranges

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39
Q

Q: Mobilization: __________ pain, __________ joint play, _____ vigorous, may ______ with it and __________ to manipulation.

A

Decrease, restore, less, start, progress

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40
Q

Q: Manipulation: ___________ pain, _________ joint motion, ________ adhesions, _________ loose bodies, requires ______ ______, when progress _________ or ___________ do not improve with the use of ______________.

A

Decrease, restore, break, remove, more, skills, plateaus, symtpoms, mobilization

41
Q

T/F: Grades 1-4 are assessment and Grade 5 is treatment

42
Q

Q: What is the biggest difference between mobilizaiton and manipulation?

A

Speed, mob = slow, manipulation = fast

43
Q

Content: PAM tests - Assessment of joint glides/accessory motion (3)

A
  1. un-restricted accessory glide
  2. excessive accessory glide
  3. restricted accessory glide
44
Q

Term: Motion limitaitons due to contractile tissues

A

Un-restricted accessory glide

45
Q

Term: Ligament or severe degeneration of joint surfaces

A

Excessive accessory glide

46
Q

Term: Limited joint glide and connective tissues

A

Restricted accessory glide

47
Q

T/F: If a pt. has CPR, a manipulation is indicated.

A

False: mobilization would be indicated

48
Q

Content: PAMS tests - Assessment of joint distraction

49
Q

Content: PAM tests - documentation (4)

A
  1. Specify direction of glide
  2. Quantity and quality of motion
  3. Reproduction of symtpoms/relief of pain
  4. Presence of muscle spasms
50
Q

Content: Incorporating mob/man into the assessment (4)

A
  1. Knowledge of joint surface and biomechanics
  2. Irritability of symtpoms
  3. Type of technique selection
  4. What is the focus of treatment - pain vs. resistance
51
Q

Content: Manual technique selection (2)

A
  1. Stages of healing vs. level of irritability
  2. Treating pain vs. resistance with mobilization
52
Q

Q: What manual technique would you choose for pain? (3)

A
  1. Least painful technique
  2. Low speed, shorter treatment (1-2 bouts of 20-30 sec)
  3. Grade 1 and 2
53
Q

Q: What manual technique would you choose for distraction that is for pain?

A

Grade 1 and 2

54
Q

Q: What manual technique would you use for spinal pain?

A

Grade 5/manipulation

55
Q

Q: What manual technique would you choose for resistance? (3)

A
  1. More end range techniques - increase vigor as tolerated
  2. Quicker speed, longer treatments (3-5 bouts of 45-60 sec)
  3. Grade 3 and 4
56
Q

Q: What manual technique would you chosse for distraction for resistance?

57
Q

Content: Manual technique selection - muscle restriction (2)

A
  1. Muscle stretching
  2. Hold/relax
58
Q

Content: Manual technique selection - joint restriction (3)

A
  1. Manipulation
  2. Grade 3 or 4 mob
  3. PPM
59
Q

Content: Manual technique selection - CPR (3)

A
  1. Grade 4 mob
  2. Prolonged stretch
  3. Distraction with or w/o movement
60
Q

Content: Manual technique selection - extreme hypomobility or pain through ROM

61
Q

Q: In what position should you perform manual techniques?

A

Loose packed, with sligh distraction

62
Q

Q: Some approaches advocate preliminary _____ ________ therapy or ____________ therapy prior to joint mobilization.

A

soft, tissue, modality

63
Q

Q: What hip glide facilitates joint mobility and pain relief?

64
Q

Q: What hip glide facilitates flexion and IR?

65
Q

Q: What hip glide facilitates extension and ER?

66
Q

Q: What hip distraction facilitates joint mobility and pain relief?

67
Q

Q: What knee PAM facilitates joint mobility and pain relief?

A

Distraction

68
Q

Q: What knee glide facilitates extension?

69
Q

Q: What knee glide facilitates flexion?

70
Q

Q: What talocural joint PAM facilitates joint mobility and pain relief?

A

Distraction

71
Q

Q: What talocural joint glide facilitates dorsiflexion?

A

Posterior or dorsal glide

72
Q

Q: What talocural joint glide facilitates plantarflexion?

A

Anterior or ventral glide

73
Q

Q: What subtalar joint PAM facilitates joint mobility and pain control?

A

Distraction

74
Q

Q: What subtalar joint glide facilitates inversion?

75
Q

Q: What subtalar joint glide facilitates eversion?

76
Q

Q: What glenohumeral joint glide facilitates ER, extension, horizontal ABD?

77
Q

Q: What glenohumeral joint glide facilitates IR, flexion, horizontal ADD?

78
Q

Q: What glenohumeral joint glide facilitates elevation?

79
Q

Q: What glenohumeral joint glide facilitates general hypomobility?

80
Q

Q: What scapular glide facilitates elevation?

81
Q

Q: What scapular glide facilitates depression?

82
Q

Q: What scapular glide facilitates ABD/Protraction?

83
Q

Q: What scapular glide facilitates ADD/retraction?

84
Q

Q: What humeroulnar PAM facilitates joint mobility?

A

Distraction

85
Q

Q: What humeroulnar glide facilitates elbow extension?

86
Q

Q: What humeroulnar glide facilitates elbow flexion?

87
Q

Q: What humeroradial PAM facilitates joint mobility?

A

Distraction

88
Q

Q: What distal radioulnar glide facilitates pronation?

89
Q

Q: What distal radioulnar glide facilitates supination?

90
Q

Q: What distal wrist/hand glide facilitates wrist extension?

91
Q

Q: What distal wrist/hand glide facilitates wrist flexion?

92
Q

Q: What distal wrist/hand glide facilitates radial deviation?

93
Q

Q: What distal wrist/hand glide facilitates ulnar deviation?

94
Q

Q: What distal MCP glide facilitates flexion?

95
Q

Q: What distal MCP glide facilitates extension?

96
Q

Q: What distal MCP glide facilitates ABD?

97
Q

Q: What distal MCP glide facilitates ADD?

98
Q

Q: What distal MCP PAM facilitates joint mobility?

PTRS 745 Exam 1 (9 decks)

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